Sorath Noorani Siddiqui, Ayesha Khan.
Ocular manifestations of acute lymphoid leukemia in children.
Al-Shifa J Ophthalmol Jan ;6(2):51-9.

Purpose: To study various ocular manifestations of Acute Lymphoid Leukemia (ALL) in children. Study Design: A prospective non interventional study. Participants and methods: This study was carried out at the department of Pediatric ophthalmology Al-Shifa Trust Eye Hospital Rawalpindi from January 2008 to June 2010. Patients with diagnosis of ALL were referred from Combined Military Hospital and Pakistan Institute of Medical Sciences. Evaluation of patients included detailed history, vision assessment, IOP recording, anterior and posterior segment examination. Children under 4 years of age were examined under sedation for IOP recording, fundus examination and fundus photography with Retcam. Results: Out of 13 patients with ALL, 7 were male and 6 female. The age of children ranged between 2.8 years to 15 years (Mean 8.5 years). Anterior segment involvement or iris infiltration was seen in 4 (30.76%) patients. Disc swelling along with venous dilation and tortuosity, round and flame shaped hemorrhages was present in 05 (38.46%) patients, while papilledema without other fundus findings was seen in 1 (7.69%) patient. One (7.69%) patient was found to have bilateral optic atrophy secondary to vincristine toxicity. One (7.69%) patient presented with pseudohypopyon in anterior chamber and choroidal detachment. Secondary acute leukemia due to etoposide toxicity was diagnosed in 01 (7.69%) patient. Conclusion: Presence of ocular involvement is associated with poor prognosis in acute childhood leukemia. It is important to consider an ophthalmic evaluation at the time of diagnosis of acute leukemia in children and adults.

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